Related health care industry news and press releases:
DME CMN FORMS DISCONTINUED AS OF 1/1/2023
All Certificates of Medical Necessity (CMNs) and Durable Medical Equipment (DME) Information Forms (DIFs) have been discontinued by CMS effective for dates of service January 1, 2023 and after.
If CMNs or DIFs, including those for oxygen, are included on electronic claims and the from date of service is on or after January 1, 2023, the claims will be rejected by CEDI. Claims with dates of service prior to January 1, 2023 should still include CMN and DIF information in accordance with DME MAC processing and policy guidelines.
TriWest VA CCN and PC3 Changes
TriWest has selected PGBA as its new Veterans Affairs (VA) Community Care Network (CCN) and Patient-Centered Community Care (PC3) claims processor.
- Claim submission instructions for the new contractor will vary for a period based on region. Providers are advised to check the authorization letter or VA’s HealthShare Referral Manager (HSRM) for the specific episode of care and should submit claims as instructed.
- There are no changes to dental or pharmacy services provided through Delta Dental or Express Scripts.
- Effective April 1, 2021: Please send CCN Region 5 claims for Kodiak, Alaska, to the new processor, PGBA.
- Effective April 1, 2021: Providers in Regions 4 and 5 are encouraged to begin the registration process for Electronic Funds Transfer (EFT) and/or Electronic Remittance Advice (ERA) with PGBA. WPS is no longer accepting new enrollments for these transactions.
- Effective June 9, 2021: All electronic transactions and paper claims for Region 4 CCN and PC3 must be sent to PGBA.
- Effective June 15, 2021: PGBA will receive and process all remaining CCN Region 5 EDI transactions.